Child (Pediatric) ENT surgery

The anatomy of an adult and a child differs not only in size, but also, in particular, in the presence of adenoid tissue in the child’s nasopharynx, a part of the immune system. If the adenoids are healthy, there is no need to remove them “just in case”. But when they themselves become a source of infection, which leads to complications (most often – otitis), you cannot do without the help of a pediatric ENT doctor in Odessa.

Possibilities of children's ENT surgery

ЛОР-хірургія — одна з найдавніших спеціалізацій в Інституті VIRTUS, тож ми маємо необхідні знання та досвід для лікування пацієнтів будь-якого віку. Всі ЛОР-операції дітям проводяться під наркозом і ендоскопічно, тож у юних пацієнтів не залишається ані жодних неприємних спогадів, ані слідів втручання.

Найчастіше ми виконуємо операції з видалення аденоїдів (ендоскопічна коблаційна аденотомія), шунтування барабанних перетинок, тонзилотомію чи тонзилектомію (повне чи часткове видалення мигдаликів) — за показаннями. Видалення аденоїдів проводиться двома способами: холодноплазменною коблацією чи шейверним ножем. Більш швидкою є коблація, до того ж цей спосіб дає змогу хірургу працювати на чистій рані, адже коблатор випаровує і коагулює тканини. Насадка на коблатор виготовляється індивідуально для кожного пацієнта.

What diseases does a pediatric ENT surgeon treat?

The task of an ENT surgeon is to ensure quality nasal breathing for both adults and children. This is especially important for a child, because if he gets used to breathing through his mouth, the structure of his lower jaw changes. As a rule, our patients, who came to us as mothers, remain with us in the future, and they can be referred by orthodontists, pediatricians or allergists for an initial appointment to VIRTUS. Often, what looks like allergic rhinitis can actually be chronic inflammation of the adenoids, and after they are removed, the child does not have any seasonal allergies. The most common complication is a chronic inflammatory process of the ears. Parents often believe that it is better not to remove anything and to preserve the adenoid tissue, because the child will eventually outgrow the disease. But such a choice leads to chronic problems that can last a lifetime (for example, hearing loss). The main diseases treated in the department of otolaryngology are the following:

• rhinitis;
• adenoiditis;
• ethmoiditis;
• otitis;
• pharyngitis;
• tonsillitis;
• laryngitis;
• injuries and foreign objects in the ENT organs.

If a child complains of pain in the ear, immediately make an appointment for a consultation – otitis should not be treated at home, because if you do not know its cause, you can waste time and face consequences that will be difficult to cope with. A runny nose or swelling of the nasal cavity, pain and sore throat that lasts longer than 3-5 days are also a reason to consult a children’s otolaryngologist. The presence of plaque on the tonsils indicates inflammation that requires treatment. An ENT surgeon can also open a boil in the nose under medicated sleep.

Services and procedures in pediatric ENT surgery

We are able not only to treat children conservatively, but also to perform operations of various levels of complexity: from classic coblation adenotomy to complex reconstruction of the larynx and trachea. Our ENT surgeons and anesthesiologists have certificates that they can work specifically with children.

All operations take place under the control of high-resolution video systems, so the doctor can carefully remove the tissue exactly where it is necessary. At the same time, we preserve the structures necessary for the child’s immunity. Even after the removal of adenoids, the baby will not get sick more often, because most of the immune system remains intact, in particular, the large lymphadenoid ring (it includes the palatine, pharyngeal, sublingual tonsils and a cluster of lymphadenoid tissue). Examination and operations for children are carried out with the help of an endoscope, which eliminates the risk of injury. Just a few hours after the operation, the kids go home from the clinic together with their parents.

Usually, the rehabilitation period passes easily and without complications, if you do not consider a stuffy nose, a feeling of running down the back wall and coughing, which quickly passes. For the first five days, the child should rest at home until the open wound surface heals, because at this time the baby’s body is open to all infections. On the 14th day after the operation, a follow-up visit is scheduled, and before that, you should also limit sports, active physical activity and swimming in the pool or open water – everything that can be associated with an increase in pressure. The doctor will allow to remove the restrictions in about a month, when the mucous membrane is fully restored.

It is important to note that we do not perform septoplasty (except for vital indications) and rhinoplasty on children under 18 (ideally, it should be done after 20).

Consultation of a pediatric ENT surgeon

A visit to the ENT surgeon does not require special preparation: the child can be washed or dripped, fed and given water. It is enough to take with you a statement about the course of the disease for the last three months.

Children’s otolaryngologists of our Institute know how to find contact with babies, so usually the consultation of the ENT surgeon takes place in the format of a game, and during the second visit the child already treats the otolaryngologist as a friend. The doctor gets to know and communicates with the child, examines his ears and nose with the help of an endoscope (we use classic funnels and nasal mirrors only in rare cases of very small children who cannot be examined endoscopically). If the baby does not make contact, because he is too scared or upset by the need to stay in the doctor’s office, and cries all the time, you can conduct an examination under sedation. Then the consultation is postponed to the next day, the parents have to bring the child on an empty stomach, and the examination takes place in the operating room. The child puts on a mask, inhales anesthetic and falls asleep, while the doctor examines him endoscopically and makes a video for the parents. If the child is already 10 years old, as an alternative, you can also conduct a CT scan.

Ideally, after a child reaches 3 years of age, it is desirable not only to consult in acute cases, but also to make an appointment with an otolaryngologist once every six months to check the condition of the adenoid tissue. You can do this in Odesa at the VIRTUS Institute, and after the second visit the child will perceive the doctor as a friend.

Delicate children's ENT surgery

Children’s ENT surgery at VIRTUS is as delicate as possible and is performed under medicated sleep conditions. Operations take place under the control of a high-resolution video system. The ability to see the smallest details of cavities and structures from the inside helps the doctor carefully remove tissue exactly where it is needed. Important structures for the child’s immunity remain preserved.

In their work, surgeons use micro-instrumentation, which eliminates the possibility of injury. Just a few hours after the operation, the kids go home from the clinic together with their parents. The postoperative period is also painless, and the risk of complications during the rehabilitation period is minimized.

Complex specialized ENT operations on children are performed in the VIRTUS operating room. For example, the reconstruction of the larynx and trachea, which is carried out by surgeon Dmytro Pilypiuk

We work in a team with specialists of various profiles. For example, pediatricians help us provide comprehensive care for babies. There are often cases when orthodontists refer to us children with malocclusion or during the planning period of bite correction. VIRTUS otolaryngologists also have appropriate certificates to provide ENT care to children.

TOP 3 pediatric ENT surgeries in VIRTUS

1. Endoscopic adenotomy – removal of adenoid tissue using cold plasma coblation or shaver.
2. Adenotonsilotomy. With hypertrophy of the tonsils in the palate, we remove the adenoid tissue and partially the palatine tonsils, thus obtaining ideal oral and nasal breathing. After surgery, children usually stop snoring and sleep peacefully, without apnea.
3. Shunting of the eardrums for chronic exudative otitis media. The decision about shunting is made directly during the operation: if, after removing the adenoids, there is still fluid behind the eardrum, a paracentesis (incision) of the membrane is performed and a shunt is installed.